Aging at Home or Elsewhere: Helping Aging Parents Make the Right Move

"Picture the scene: parents aren't eating properly, they have deteriorated medically, the bills aren't paid, the mail has piled up, the laundry isn't done, clutter is everywhere."

These are "typical crises" that prompt adult children to "run to put them (their parents) in assisted living prematurely," says J. Donna Sullivan, LCSW, and Director of Older Adult Services for the Scarsdale and Edgemont Family Counseling  Service.  "It's premature," she says, "because their parents could continue to live fairly independently for another 5-6 years if they took advantage of services that are available in almost all communities."

"What I've seen most is the deterioration of older people's health because they're physically not able to get to doctors or dentists or get their hearing aid batteries...There are services to assist them with meals, transportation, with housekeeping--but they're not getting them.  The bills aren't paid and the mail piles up because they can't see well and need new glasses and ultimately it gets to crisis mode.  These older people need care management, not assisted living."

It's common knowledge that most people who can remain in their own homes as they age do better.  Why?

• Home is an anchor offering comfort and the familiar.
• Feelings of independence and self-worth remain in tact.
• The familiar neighborhood often still provides connections with others.
• The well-known physical structure of the home instills the confidence to move about freely within its walls, contributing to mobility and physical well-being unless stairs are an issue.

This probably means it's in most aging parents' best interest when we can help them remain in their homes as long as possible (and it will no doubt make us happier too).  Thus, we may need to find out more about--then use--some of the new technology featured in the last two posts, as well as older technology like the pendant one pushes in an emergency.

If this doesn't seem doable, your parent's doctor should know the kind of living situation most suitable for your parents; or a social worker or a geriatric care manager can assess your aging parent's situation and make recommendations.

Knowing how important "home" is, raises 3 important questions:

1. "Is it better to respect parents' wishes about where they live--even if it makes it  more  difficult for us?
2. "How can we make it work?"
3. "If we can't make it work, how do we--and our parents--go about finding a suitable living situation elsewhere?

"Elsewhere" will be addressed in this coming Saturday's post.

Driving (or Not) Part 4

I’ve forgotten whether Dad’s driver’s license came up for renewal the year before or the year after his 90th birthday. What I do remember is the fact that it was renewed for 8 or 10 years!

Also surprising: Dad went to the DMV bureau in a smaller town (he lived in a city) 20 minutes away. It was easy to park there; they were nice. He had a habit of keeping his driver’s license and all credit cards, but one, hidden in the trunk of his car. As he began the renewal process he realized he didn’t have his soon-to-expire license and told the DMV person that it was in the trunk of his car; he’d get it. No problem--the computer could access data. He only needed proof of who he was. The only “document” that had his name: a Safeway Grocery Store club membership card in his pocket. Proof of ID accepted. Renewal granted.

Fact: Some older drivers (and others) drive under “ify” circumstances.
Fact: When it’s threatening to life and limb, prevention is key.
Fact: Parents resent being forced to do something, just as we would resent our children forcing us to do something.
Fact: The entities and agencies, you would expect help from, may be of little or no help.

We all agree that we must stop parents who drive dangerously, but how do we do it without straining family relationships? If you're an only child, it's your burden. If there are siblings and the majority or all agree, great! If you don't agree, see information in #4.

#1. What seems like a major problem, may be easily solved (could be medications or a case like Kim’s mother). Remind mentally able parents of this. By pulling then into the situation and saying the problem may be easily solved, it's respectful, empowering, and helps them buy into whatever may come. To rule out serious problems, with your parents agreeing and perhaps making the call, first consult the primary care doctor, which may lead to additional testing (eg. vision, neurological).

#2. If it’s not correctable, the doctor is in the best position to deliver the message. This is a huge loss, a chunk of life is being removed. Doctors have practice in delivering bad news and hopefully do it in a kind, objective manner.

#3. Many adult children have phoned police, insurance companies, DMV etc., in efforts to curtail parents’ driving, and the results vary. It’s sneaky, which is disrespectful and undermines self-esteem among other things. Understandably children usually don’t feel good about it. Only as a last resort, it may have merit.

#4. If we must deliver the no-more-driving message, how can we give facts, affirm our parents’ ability to participate in the decision-making and arrive at a no-more-driving result? If we're uncomfortable with that responsibility, a social worker experienced with the elderly can be a big help. Contact a local family counseling agency or an agency whose social workers specialize in geriatrics. It definitely won't be the first time they've helped adult children with this problem.